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Service Code HCPCS J0290
Hospital Revenue Code 636
Min. Negotiated Rate $21.97
Max. Negotiated Rate $39.88
Rate for Payer: Aetna of WY Commercial/Medical Rental $39.08
Rate for Payer: Aetna of WY Commercial/Medical Rental $39.07
Rate for Payer: Aetna of WY Medicare $26.32
Rate for Payer: Aetna of WY Medicare $26.31
Rate for Payer: Altius Auto/Workers Compensation $38.28
Rate for Payer: Altius Auto/Workers Compensation $38.28
Rate for Payer: Altius Commercial $38.28
Rate for Payer: Altius Commercial $38.28
Rate for Payer: Beech Street Commercial $39.07
Rate for Payer: Beech Street Commercial $39.08
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $32.74
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $32.73
Rate for Payer: Cash Price $27.91
Rate for Payer: Cash Price $27.92
Rate for Payer: ChoiceCare Network Commercial $38.68
Rate for Payer: ChoiceCare Network Commercial $38.67
Rate for Payer: Cigna of WY Commercial $39.07
Rate for Payer: Cigna of WY Commercial $39.08
Rate for Payer: Entrust Commercial $37.89
Rate for Payer: Entrust Commercial $37.88
Rate for Payer: First Choice Health Commercial $37.88
Rate for Payer: First Choice Health Commercial $37.89
Rate for Payer: Government Employees Health Association (GEHA) Commercial $37.88
Rate for Payer: Government Employees Health Association (GEHA) Commercial $37.89
Rate for Payer: Government Employees Health Association (GEHA) Medicare $23.13
Rate for Payer: Government Employees Health Association (GEHA) Medicare $23.12
Rate for Payer: HealthUtah PPO $39.87
Rate for Payer: HealthUtah PPO $39.88
Rate for Payer: Idaho Integrated Healthcare Commercial $38.67
Rate for Payer: Idaho Integrated Healthcare Commercial $38.68
Rate for Payer: Multiplan Medicare/VA $21.97
Rate for Payer: Multiplan Medicare/VA $21.97
Rate for Payer: One Health Plan of WY PPO $39.07
Rate for Payer: One Health Plan of WY PPO $39.08
Rate for Payer: PacificSource Commercial $35.89
Rate for Payer: PacificSource Commercial $35.88
Rate for Payer: PHCS PPO $39.07
Rate for Payer: PHCS PPO $39.08
Rate for Payer: Three Rivers PPO $29.90
Rate for Payer: Three Rivers PPO $29.91
Rate for Payer: TriWest Veterans Administration $23.13
Rate for Payer: TriWest Veterans Administration $23.12
Rate for Payer: United Healthcare Commercial $34.69
Rate for Payer: United Healthcare Commercial $34.70
Rate for Payer: United Healthcare Medicare $23.13
Rate for Payer: United Healthcare Medicare $23.12
Rate for Payer: WINHealth Partners Commercial $39.07
Rate for Payer: WINHealth Partners Commercial $39.08
Rate for Payer: Wise Provider Network Commercial $37.88
Rate for Payer: Wise Provider Network Commercial $37.89
Service Code HCPCS J0290
Hospital Revenue Code 636
Min. Negotiated Rate $25.00
Max. Negotiated Rate $39.88
Rate for Payer: Aetna of WY Commercial/Medical Rental $39.08
Rate for Payer: Aetna of WY Commercial/Medical Rental $39.07
Rate for Payer: Altius Auto/Workers Compensation $38.28
Rate for Payer: Altius Auto/Workers Compensation $38.28
Rate for Payer: Altius Commercial $38.28
Rate for Payer: Altius Commercial $38.28
Rate for Payer: Beech Street Commercial $39.08
Rate for Payer: Beech Street Commercial $39.07
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $32.73
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $32.74
Rate for Payer: Cash Price $27.92
Rate for Payer: Cash Price $27.91
Rate for Payer: ChoiceCare Network Commercial $38.67
Rate for Payer: ChoiceCare Network Commercial $38.68
Rate for Payer: Cigna of WY Commercial $39.08
Rate for Payer: Cigna of WY Commercial $39.07
Rate for Payer: Entrust Commercial $37.88
Rate for Payer: Entrust Commercial $37.89
Rate for Payer: First Choice Health Commercial $37.88
Rate for Payer: First Choice Health Commercial $37.89
Rate for Payer: Government Employees Health Association (GEHA) Commercial $37.88
Rate for Payer: Government Employees Health Association (GEHA) Commercial $37.89
Rate for Payer: Government Employees Health Association (GEHA) Medicare $26.32
Rate for Payer: Government Employees Health Association (GEHA) Medicare $26.31
Rate for Payer: HealthUtah PPO $39.88
Rate for Payer: HealthUtah PPO $39.87
Rate for Payer: Idaho Integrated Healthcare Commercial $38.67
Rate for Payer: Idaho Integrated Healthcare Commercial $38.68
Rate for Payer: Multiplan Medicare/VA $25.00
Rate for Payer: Multiplan Medicare/VA $25.00
Rate for Payer: One Health Plan of WY PPO $39.08
Rate for Payer: One Health Plan of WY PPO $39.07
Rate for Payer: PacificSource Commercial $35.89
Rate for Payer: PacificSource Commercial $35.88
Rate for Payer: PHCS PPO $39.07
Rate for Payer: PHCS PPO $39.08
Rate for Payer: Three Rivers PPO $29.90
Rate for Payer: Three Rivers PPO $29.91
Rate for Payer: TriWest Veterans Administration $26.32
Rate for Payer: TriWest Veterans Administration $26.31
Rate for Payer: United Healthcare Commercial $34.69
Rate for Payer: United Healthcare Commercial $34.70
Rate for Payer: United Healthcare Medicare $26.32
Rate for Payer: United Healthcare Medicare $26.31
Rate for Payer: WINHealth Partners Commercial $37.88
Rate for Payer: WINHealth Partners Commercial $37.89
Rate for Payer: Wise Provider Network Commercial $37.88
Rate for Payer: Wise Provider Network Commercial $37.89
Service Code HCPCS J0290
Hospital Charge Code J0290
Min. Negotiated Rate $0.85
Max. Negotiated Rate $2.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1.96
Rate for Payer: Aetna of WY Medicare $1.00
Rate for Payer: Beech Street Commercial $1.90
Rate for Payer: Cash Price $1.40
Rate for Payer: Cash Price $1.40
Rate for Payer: ChoiceCare Network Commercial $1.94
Rate for Payer: Cigna of WY Commercial $1.96
Rate for Payer: First Choice Health Commercial $1.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1.90
Rate for Payer: Government Employees Health Association (GEHA) Medicare $1.00
Rate for Payer: HealthUtah PPO $2.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1.94
Rate for Payer: Multiplan Medicare/VA $0.85
Rate for Payer: One Health Plan of WY PPO $1.96
Rate for Payer: PacificSource Commercial $1.80
Rate for Payer: PHCS PPO $1.90
Rate for Payer: Three Rivers PPO $1.50
Rate for Payer: TriWest Veterans Administration $1.00
Rate for Payer: United Healthcare Commercial $1.74
Rate for Payer: United Healthcare Medicare $1.00
Rate for Payer: WINHealth Partners Commercial $1.90
Service Code HCPCS J0290
Hospital Revenue Code 636
Min. Negotiated Rate $16.03
Max. Negotiated Rate $25.57
Rate for Payer: Aetna of WY Commercial/Medical Rental $25.06
Rate for Payer: Aetna of WY Commercial/Medical Rental $23.85
Rate for Payer: Altius Auto/Workers Compensation $24.55
Rate for Payer: Altius Auto/Workers Compensation $23.37
Rate for Payer: Altius Commercial $23.37
Rate for Payer: Altius Commercial $24.55
Rate for Payer: Beech Street Commercial $25.06
Rate for Payer: Beech Street Commercial $23.85
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $19.98
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $20.99
Rate for Payer: Cash Price $17.90
Rate for Payer: Cash Price $17.04
Rate for Payer: ChoiceCare Network Commercial $23.61
Rate for Payer: ChoiceCare Network Commercial $24.80
Rate for Payer: Cigna of WY Commercial $25.06
Rate for Payer: Cigna of WY Commercial $23.85
Rate for Payer: Entrust Commercial $23.12
Rate for Payer: Entrust Commercial $24.29
Rate for Payer: First Choice Health Commercial $23.12
Rate for Payer: First Choice Health Commercial $24.29
Rate for Payer: Government Employees Health Association (GEHA) Commercial $23.12
Rate for Payer: Government Employees Health Association (GEHA) Commercial $24.29
Rate for Payer: Government Employees Health Association (GEHA) Medicare $16.88
Rate for Payer: Government Employees Health Association (GEHA) Medicare $16.06
Rate for Payer: HealthUtah PPO $25.57
Rate for Payer: HealthUtah PPO $24.34
Rate for Payer: Idaho Integrated Healthcare Commercial $23.61
Rate for Payer: Idaho Integrated Healthcare Commercial $24.80
Rate for Payer: Multiplan Medicare/VA $16.03
Rate for Payer: Multiplan Medicare/VA $15.26
Rate for Payer: One Health Plan of WY PPO $25.06
Rate for Payer: One Health Plan of WY PPO $23.85
Rate for Payer: PacificSource Commercial $23.01
Rate for Payer: PacificSource Commercial $21.91
Rate for Payer: PHCS PPO $23.85
Rate for Payer: PHCS PPO $25.06
Rate for Payer: Three Rivers PPO $18.26
Rate for Payer: Three Rivers PPO $19.18
Rate for Payer: TriWest Veterans Administration $16.88
Rate for Payer: TriWest Veterans Administration $16.06
Rate for Payer: United Healthcare Commercial $21.18
Rate for Payer: United Healthcare Commercial $22.25
Rate for Payer: United Healthcare Medicare $16.88
Rate for Payer: United Healthcare Medicare $16.06
Rate for Payer: WINHealth Partners Commercial $23.12
Rate for Payer: WINHealth Partners Commercial $24.29
Rate for Payer: Wise Provider Network Commercial $23.12
Rate for Payer: Wise Provider Network Commercial $24.29
Service Code HCPCS J0290
Hospital Revenue Code 636
Min. Negotiated Rate $14.09
Max. Negotiated Rate $25.57
Rate for Payer: Aetna of WY Commercial/Medical Rental $25.06
Rate for Payer: Aetna of WY Commercial/Medical Rental $23.85
Rate for Payer: Aetna of WY Medicare $16.88
Rate for Payer: Aetna of WY Medicare $16.06
Rate for Payer: Altius Auto/Workers Compensation $23.37
Rate for Payer: Altius Auto/Workers Compensation $24.55
Rate for Payer: Altius Commercial $24.55
Rate for Payer: Altius Commercial $23.37
Rate for Payer: Beech Street Commercial $23.85
Rate for Payer: Beech Street Commercial $25.06
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $20.99
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $19.98
Rate for Payer: Cash Price $17.04
Rate for Payer: Cash Price $17.90
Rate for Payer: ChoiceCare Network Commercial $24.80
Rate for Payer: ChoiceCare Network Commercial $23.61
Rate for Payer: Cigna of WY Commercial $23.85
Rate for Payer: Cigna of WY Commercial $25.06
Rate for Payer: Entrust Commercial $24.29
Rate for Payer: Entrust Commercial $23.12
Rate for Payer: First Choice Health Commercial $23.12
Rate for Payer: First Choice Health Commercial $24.29
Rate for Payer: Government Employees Health Association (GEHA) Commercial $23.12
Rate for Payer: Government Employees Health Association (GEHA) Commercial $24.29
Rate for Payer: Government Employees Health Association (GEHA) Medicare $14.83
Rate for Payer: Government Employees Health Association (GEHA) Medicare $14.12
Rate for Payer: HealthUtah PPO $24.34
Rate for Payer: HealthUtah PPO $25.57
Rate for Payer: Idaho Integrated Healthcare Commercial $23.61
Rate for Payer: Idaho Integrated Healthcare Commercial $24.80
Rate for Payer: Multiplan Medicare/VA $14.09
Rate for Payer: Multiplan Medicare/VA $13.41
Rate for Payer: One Health Plan of WY PPO $23.85
Rate for Payer: One Health Plan of WY PPO $25.06
Rate for Payer: PacificSource Commercial $23.01
Rate for Payer: PacificSource Commercial $21.91
Rate for Payer: PHCS PPO $23.85
Rate for Payer: PHCS PPO $25.06
Rate for Payer: Three Rivers PPO $18.26
Rate for Payer: Three Rivers PPO $19.18
Rate for Payer: TriWest Veterans Administration $14.83
Rate for Payer: TriWest Veterans Administration $14.12
Rate for Payer: United Healthcare Commercial $21.18
Rate for Payer: United Healthcare Commercial $22.25
Rate for Payer: United Healthcare Medicare $14.83
Rate for Payer: United Healthcare Medicare $14.12
Rate for Payer: WINHealth Partners Commercial $23.85
Rate for Payer: WINHealth Partners Commercial $25.06
Rate for Payer: Wise Provider Network Commercial $23.12
Rate for Payer: Wise Provider Network Commercial $24.29
Service Code HCPCS J0295
Hospital Revenue Code 636
Min. Negotiated Rate $25.61
Max. Negotiated Rate $40.84
Rate for Payer: Aetna of WY Commercial/Medical Rental $40.02
Rate for Payer: Aetna of WY Commercial/Medical Rental $33.56
Rate for Payer: Altius Auto/Workers Compensation $39.21
Rate for Payer: Altius Auto/Workers Compensation $32.88
Rate for Payer: Altius Commercial $32.88
Rate for Payer: Altius Commercial $39.21
Rate for Payer: Beech Street Commercial $40.02
Rate for Payer: Beech Street Commercial $33.56
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $28.12
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $33.53
Rate for Payer: Cash Price $28.59
Rate for Payer: Cash Price $23.97
Rate for Payer: ChoiceCare Network Commercial $33.22
Rate for Payer: ChoiceCare Network Commercial $39.61
Rate for Payer: Cigna of WY Commercial $40.02
Rate for Payer: Cigna of WY Commercial $33.56
Rate for Payer: Entrust Commercial $32.54
Rate for Payer: Entrust Commercial $38.80
Rate for Payer: First Choice Health Commercial $32.54
Rate for Payer: First Choice Health Commercial $38.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $32.54
Rate for Payer: Government Employees Health Association (GEHA) Commercial $38.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $26.95
Rate for Payer: Government Employees Health Association (GEHA) Medicare $22.60
Rate for Payer: HealthUtah PPO $40.84
Rate for Payer: HealthUtah PPO $34.25
Rate for Payer: Idaho Integrated Healthcare Commercial $33.22
Rate for Payer: Idaho Integrated Healthcare Commercial $39.61
Rate for Payer: Multiplan Medicare/VA $25.61
Rate for Payer: Multiplan Medicare/VA $21.47
Rate for Payer: One Health Plan of WY PPO $40.02
Rate for Payer: One Health Plan of WY PPO $33.56
Rate for Payer: PacificSource Commercial $36.76
Rate for Payer: PacificSource Commercial $30.82
Rate for Payer: PHCS PPO $33.56
Rate for Payer: PHCS PPO $40.02
Rate for Payer: Three Rivers PPO $25.69
Rate for Payer: Three Rivers PPO $30.63
Rate for Payer: TriWest Veterans Administration $26.95
Rate for Payer: TriWest Veterans Administration $22.60
Rate for Payer: United Healthcare Commercial $29.80
Rate for Payer: United Healthcare Commercial $35.53
Rate for Payer: United Healthcare Medicare $26.95
Rate for Payer: United Healthcare Medicare $22.60
Rate for Payer: WINHealth Partners Commercial $32.54
Rate for Payer: WINHealth Partners Commercial $38.80
Rate for Payer: Wise Provider Network Commercial $32.54
Rate for Payer: Wise Provider Network Commercial $38.80
Service Code HCPCS J0295
Hospital Revenue Code 636
Min. Negotiated Rate $22.50
Max. Negotiated Rate $40.84
Rate for Payer: Aetna of WY Commercial/Medical Rental $40.02
Rate for Payer: Aetna of WY Commercial/Medical Rental $33.56
Rate for Payer: Aetna of WY Medicare $26.95
Rate for Payer: Aetna of WY Medicare $22.60
Rate for Payer: Altius Auto/Workers Compensation $32.88
Rate for Payer: Altius Auto/Workers Compensation $39.21
Rate for Payer: Altius Commercial $39.21
Rate for Payer: Altius Commercial $32.88
Rate for Payer: Beech Street Commercial $33.56
Rate for Payer: Beech Street Commercial $40.02
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $33.53
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $28.12
Rate for Payer: Cash Price $23.97
Rate for Payer: Cash Price $28.59
Rate for Payer: ChoiceCare Network Commercial $39.61
Rate for Payer: ChoiceCare Network Commercial $33.22
Rate for Payer: Cigna of WY Commercial $33.56
Rate for Payer: Cigna of WY Commercial $40.02
Rate for Payer: Entrust Commercial $38.80
Rate for Payer: Entrust Commercial $32.54
Rate for Payer: First Choice Health Commercial $32.54
Rate for Payer: First Choice Health Commercial $38.80
Rate for Payer: Government Employees Health Association (GEHA) Commercial $32.54
Rate for Payer: Government Employees Health Association (GEHA) Commercial $38.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $23.69
Rate for Payer: Government Employees Health Association (GEHA) Medicare $19.86
Rate for Payer: HealthUtah PPO $34.25
Rate for Payer: HealthUtah PPO $40.84
Rate for Payer: Idaho Integrated Healthcare Commercial $33.22
Rate for Payer: Idaho Integrated Healthcare Commercial $39.61
Rate for Payer: Multiplan Medicare/VA $22.50
Rate for Payer: Multiplan Medicare/VA $18.87
Rate for Payer: One Health Plan of WY PPO $33.56
Rate for Payer: One Health Plan of WY PPO $40.02
Rate for Payer: PacificSource Commercial $36.76
Rate for Payer: PacificSource Commercial $30.82
Rate for Payer: PHCS PPO $33.56
Rate for Payer: PHCS PPO $40.02
Rate for Payer: Three Rivers PPO $25.69
Rate for Payer: Three Rivers PPO $30.63
Rate for Payer: TriWest Veterans Administration $23.69
Rate for Payer: TriWest Veterans Administration $19.86
Rate for Payer: United Healthcare Commercial $29.80
Rate for Payer: United Healthcare Commercial $35.53
Rate for Payer: United Healthcare Medicare $23.69
Rate for Payer: United Healthcare Medicare $19.86
Rate for Payer: WINHealth Partners Commercial $33.56
Rate for Payer: WINHealth Partners Commercial $40.02
Rate for Payer: Wise Provider Network Commercial $32.54
Rate for Payer: Wise Provider Network Commercial $38.80
Service Code HCPCS J0295
Hospital Revenue Code 636
Min. Negotiated Rate $34.41
Max. Negotiated Rate $54.88
Rate for Payer: Aetna of WY Commercial/Medical Rental $53.78
Rate for Payer: Altius Auto/Workers Compensation $52.68
Rate for Payer: Altius Commercial $52.68
Rate for Payer: Beech Street Commercial $53.78
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $45.06
Rate for Payer: Cash Price $38.41
Rate for Payer: ChoiceCare Network Commercial $53.23
Rate for Payer: Cigna of WY Commercial $53.78
Rate for Payer: Entrust Commercial $52.14
Rate for Payer: First Choice Health Commercial $52.14
Rate for Payer: Government Employees Health Association (GEHA) Commercial $52.14
Rate for Payer: Government Employees Health Association (GEHA) Medicare $36.22
Rate for Payer: HealthUtah PPO $54.88
Rate for Payer: Idaho Integrated Healthcare Commercial $53.23
Rate for Payer: Multiplan Medicare/VA $34.41
Rate for Payer: One Health Plan of WY PPO $53.78
Rate for Payer: PacificSource Commercial $49.39
Rate for Payer: PHCS PPO $53.78
Rate for Payer: Three Rivers PPO $41.16
Rate for Payer: TriWest Veterans Administration $36.22
Rate for Payer: United Healthcare Commercial $47.75
Rate for Payer: United Healthcare Medicare $36.22
Rate for Payer: WINHealth Partners Commercial $52.14
Rate for Payer: Wise Provider Network Commercial $52.14
Service Code HCPCS J0295
Hospital Revenue Code 636
Min. Negotiated Rate $30.24
Max. Negotiated Rate $54.88
Rate for Payer: Aetna of WY Commercial/Medical Rental $53.78
Rate for Payer: Aetna of WY Medicare $36.22
Rate for Payer: Altius Auto/Workers Compensation $52.68
Rate for Payer: Altius Commercial $52.68
Rate for Payer: Beech Street Commercial $53.78
Rate for Payer: Blue Cross Blue Shield of Wyoming Commercial $45.06
Rate for Payer: Cash Price $38.41
Rate for Payer: ChoiceCare Network Commercial $53.23
Rate for Payer: Cigna of WY Commercial $53.78
Rate for Payer: Entrust Commercial $52.14
Rate for Payer: First Choice Health Commercial $52.14
Rate for Payer: Government Employees Health Association (GEHA) Commercial $52.14
Rate for Payer: Government Employees Health Association (GEHA) Medicare $31.83
Rate for Payer: HealthUtah PPO $54.88
Rate for Payer: Idaho Integrated Healthcare Commercial $53.23
Rate for Payer: Multiplan Medicare/VA $30.24
Rate for Payer: One Health Plan of WY PPO $53.78
Rate for Payer: PacificSource Commercial $49.39
Rate for Payer: PHCS PPO $53.78
Rate for Payer: Three Rivers PPO $41.16
Rate for Payer: TriWest Veterans Administration $31.83
Rate for Payer: United Healthcare Commercial $47.75
Rate for Payer: United Healthcare Medicare $31.83
Rate for Payer: WINHealth Partners Commercial $53.78
Rate for Payer: Wise Provider Network Commercial $52.14
Service Code HCPCS 27886
Hospital Charge Code 27886
Min. Negotiated Rate $524.98
Max. Negotiated Rate $2,204.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,159.92
Rate for Payer: Aetna of WY Medicare $617.62
Rate for Payer: Beech Street Commercial $2,093.80
Rate for Payer: Cash Price $1,542.80
Rate for Payer: Cash Price $1,542.80
Rate for Payer: ChoiceCare Network Commercial $2,137.88
Rate for Payer: Cigna of WY Commercial $2,159.92
Rate for Payer: First Choice Health Commercial $1,983.60
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,093.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $617.62
Rate for Payer: HealthUtah PPO $2,204.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,137.88
Rate for Payer: Multiplan Medicare/VA $524.98
Rate for Payer: One Health Plan of WY PPO $2,159.92
Rate for Payer: PacificSource Commercial $1,983.60
Rate for Payer: PHCS PPO $2,093.80
Rate for Payer: Three Rivers PPO $1,653.00
Rate for Payer: TriWest Veterans Administration $617.62
Rate for Payer: United Healthcare Commercial $1,917.48
Rate for Payer: United Healthcare Medicare $617.62
Rate for Payer: WINHealth Partners Commercial $1,873.40
Service Code HCPCS 27886 AS
Hospital Charge Code 27886
Min. Negotiated Rate $524.98
Max. Negotiated Rate $2,204.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,159.92
Rate for Payer: Aetna of WY Medicare $617.62
Rate for Payer: Beech Street Commercial $2,093.80
Rate for Payer: Cash Price $1,542.80
Rate for Payer: Cash Price $1,542.80
Rate for Payer: ChoiceCare Network Commercial $2,137.88
Rate for Payer: Cigna of WY Commercial $2,159.92
Rate for Payer: First Choice Health Commercial $1,983.60
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,093.80
Rate for Payer: Government Employees Health Association (GEHA) Medicare $617.62
Rate for Payer: HealthUtah PPO $2,204.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,137.88
Rate for Payer: Multiplan Medicare/VA $524.98
Rate for Payer: One Health Plan of WY PPO $2,159.92
Rate for Payer: PacificSource Commercial $1,983.60
Rate for Payer: PHCS PPO $2,093.80
Rate for Payer: Three Rivers PPO $1,653.00
Rate for Payer: TriWest Veterans Administration $617.62
Rate for Payer: United Healthcare Commercial $1,917.48
Rate for Payer: United Healthcare Medicare $617.62
Rate for Payer: WINHealth Partners Commercial $1,873.40
Service Code HCPCS 26910
Hospital Charge Code 26910
Min. Negotiated Rate $633.28
Max. Negotiated Rate $2,658.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,604.84
Rate for Payer: Aetna of WY Medicare $745.04
Rate for Payer: Beech Street Commercial $2,525.10
Rate for Payer: Cash Price $1,860.60
Rate for Payer: Cash Price $1,860.60
Rate for Payer: ChoiceCare Network Commercial $2,578.26
Rate for Payer: Cigna of WY Commercial $2,604.84
Rate for Payer: First Choice Health Commercial $2,392.20
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,525.10
Rate for Payer: Government Employees Health Association (GEHA) Medicare $745.04
Rate for Payer: HealthUtah PPO $2,658.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,578.26
Rate for Payer: Multiplan Medicare/VA $633.28
Rate for Payer: One Health Plan of WY PPO $2,604.84
Rate for Payer: PacificSource Commercial $2,392.20
Rate for Payer: PHCS PPO $2,525.10
Rate for Payer: Three Rivers PPO $1,993.50
Rate for Payer: TriWest Veterans Administration $745.04
Rate for Payer: United Healthcare Commercial $2,312.46
Rate for Payer: United Healthcare Medicare $745.04
Rate for Payer: WINHealth Partners Commercial $2,259.30
Service Code HCPCS 26910 80
Hospital Charge Code 26910
Min. Negotiated Rate $633.28
Max. Negotiated Rate $2,658.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,604.84
Rate for Payer: Aetna of WY Medicare $745.04
Rate for Payer: Beech Street Commercial $2,525.10
Rate for Payer: Cash Price $1,860.60
Rate for Payer: Cash Price $1,860.60
Rate for Payer: ChoiceCare Network Commercial $2,578.26
Rate for Payer: Cigna of WY Commercial $2,604.84
Rate for Payer: First Choice Health Commercial $2,392.20
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,525.10
Rate for Payer: Government Employees Health Association (GEHA) Medicare $745.04
Rate for Payer: HealthUtah PPO $2,658.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,578.26
Rate for Payer: Multiplan Medicare/VA $633.28
Rate for Payer: One Health Plan of WY PPO $2,604.84
Rate for Payer: PacificSource Commercial $2,392.20
Rate for Payer: PHCS PPO $2,525.10
Rate for Payer: Three Rivers PPO $1,993.50
Rate for Payer: TriWest Veterans Administration $745.04
Rate for Payer: United Healthcare Commercial $2,312.46
Rate for Payer: United Healthcare Medicare $745.04
Rate for Payer: WINHealth Partners Commercial $2,259.30
Service Code HCPCS 28800
Hospital Charge Code 28800
Min. Negotiated Rate $434.79
Max. Negotiated Rate $2,637.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,584.26
Rate for Payer: Aetna of WY Medicare $511.52
Rate for Payer: Beech Street Commercial $2,505.15
Rate for Payer: Cash Price $1,845.90
Rate for Payer: Cash Price $1,845.90
Rate for Payer: ChoiceCare Network Commercial $2,557.89
Rate for Payer: Cigna of WY Commercial $2,584.26
Rate for Payer: First Choice Health Commercial $2,373.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,505.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $511.52
Rate for Payer: HealthUtah PPO $2,637.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,557.89
Rate for Payer: Multiplan Medicare/VA $434.79
Rate for Payer: One Health Plan of WY PPO $2,584.26
Rate for Payer: PacificSource Commercial $2,373.30
Rate for Payer: PHCS PPO $2,505.15
Rate for Payer: Three Rivers PPO $1,977.75
Rate for Payer: TriWest Veterans Administration $511.52
Rate for Payer: United Healthcare Commercial $2,294.19
Rate for Payer: United Healthcare Medicare $511.52
Rate for Payer: WINHealth Partners Commercial $2,241.45
Service Code HCPCS 28805 AS
Hospital Charge Code 28805
Min. Negotiated Rate $577.67
Max. Negotiated Rate $2,425.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,376.50
Rate for Payer: Aetna of WY Medicare $679.61
Rate for Payer: Beech Street Commercial $2,303.75
Rate for Payer: Cash Price $1,697.50
Rate for Payer: Cash Price $1,697.50
Rate for Payer: ChoiceCare Network Commercial $2,352.25
Rate for Payer: Cigna of WY Commercial $2,376.50
Rate for Payer: First Choice Health Commercial $2,182.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,303.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $679.61
Rate for Payer: HealthUtah PPO $2,425.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,352.25
Rate for Payer: Multiplan Medicare/VA $577.67
Rate for Payer: One Health Plan of WY PPO $2,376.50
Rate for Payer: PacificSource Commercial $2,182.50
Rate for Payer: PHCS PPO $2,303.75
Rate for Payer: Three Rivers PPO $1,818.75
Rate for Payer: TriWest Veterans Administration $679.61
Rate for Payer: United Healthcare Commercial $2,109.75
Rate for Payer: United Healthcare Medicare $679.61
Rate for Payer: WINHealth Partners Commercial $2,061.25
Service Code HCPCS 28805
Hospital Charge Code 28805
Min. Negotiated Rate $577.67
Max. Negotiated Rate $2,425.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,376.50
Rate for Payer: Aetna of WY Medicare $679.61
Rate for Payer: Beech Street Commercial $2,303.75
Rate for Payer: Cash Price $1,697.50
Rate for Payer: Cash Price $1,697.50
Rate for Payer: ChoiceCare Network Commercial $2,352.25
Rate for Payer: Cigna of WY Commercial $2,376.50
Rate for Payer: First Choice Health Commercial $2,182.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,303.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $679.61
Rate for Payer: HealthUtah PPO $2,425.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,352.25
Rate for Payer: Multiplan Medicare/VA $577.67
Rate for Payer: One Health Plan of WY PPO $2,376.50
Rate for Payer: PacificSource Commercial $2,182.50
Rate for Payer: PHCS PPO $2,303.75
Rate for Payer: Three Rivers PPO $1,818.75
Rate for Payer: TriWest Veterans Administration $679.61
Rate for Payer: United Healthcare Commercial $2,109.75
Rate for Payer: United Healthcare Medicare $679.61
Rate for Payer: WINHealth Partners Commercial $2,061.25
Service Code HCPCS 28805 80
Hospital Charge Code 28805
Min. Negotiated Rate $577.67
Max. Negotiated Rate $2,425.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,376.50
Rate for Payer: Aetna of WY Medicare $679.61
Rate for Payer: Beech Street Commercial $2,303.75
Rate for Payer: Cash Price $1,697.50
Rate for Payer: Cash Price $1,697.50
Rate for Payer: ChoiceCare Network Commercial $2,352.25
Rate for Payer: Cigna of WY Commercial $2,376.50
Rate for Payer: First Choice Health Commercial $2,182.50
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,303.75
Rate for Payer: Government Employees Health Association (GEHA) Medicare $679.61
Rate for Payer: HealthUtah PPO $2,425.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,352.25
Rate for Payer: Multiplan Medicare/VA $577.67
Rate for Payer: One Health Plan of WY PPO $2,376.50
Rate for Payer: PacificSource Commercial $2,182.50
Rate for Payer: PHCS PPO $2,303.75
Rate for Payer: Three Rivers PPO $1,818.75
Rate for Payer: TriWest Veterans Administration $679.61
Rate for Payer: United Healthcare Commercial $2,109.75
Rate for Payer: United Healthcare Medicare $679.61
Rate for Payer: WINHealth Partners Commercial $2,061.25
Service Code HCPCS 27880 80
Hospital Charge Code 27880
Min. Negotiated Rate $720.44
Max. Negotiated Rate $3,026.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,965.48
Rate for Payer: Aetna of WY Medicare $847.58
Rate for Payer: Beech Street Commercial $2,874.70
Rate for Payer: Cash Price $2,118.20
Rate for Payer: Cash Price $2,118.20
Rate for Payer: ChoiceCare Network Commercial $2,935.22
Rate for Payer: Cigna of WY Commercial $2,965.48
Rate for Payer: First Choice Health Commercial $2,723.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,874.70
Rate for Payer: Government Employees Health Association (GEHA) Medicare $847.58
Rate for Payer: HealthUtah PPO $3,026.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,935.22
Rate for Payer: Multiplan Medicare/VA $720.44
Rate for Payer: One Health Plan of WY PPO $2,965.48
Rate for Payer: PacificSource Commercial $2,723.40
Rate for Payer: PHCS PPO $2,874.70
Rate for Payer: Three Rivers PPO $2,269.50
Rate for Payer: TriWest Veterans Administration $847.58
Rate for Payer: United Healthcare Commercial $2,632.62
Rate for Payer: United Healthcare Medicare $847.58
Rate for Payer: WINHealth Partners Commercial $2,572.10
Service Code HCPCS 27880
Hospital Charge Code 27880
Min. Negotiated Rate $720.44
Max. Negotiated Rate $3,026.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,965.48
Rate for Payer: Aetna of WY Medicare $847.58
Rate for Payer: Beech Street Commercial $2,874.70
Rate for Payer: Cash Price $2,118.20
Rate for Payer: Cash Price $2,118.20
Rate for Payer: ChoiceCare Network Commercial $2,935.22
Rate for Payer: Cigna of WY Commercial $2,965.48
Rate for Payer: First Choice Health Commercial $2,723.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,874.70
Rate for Payer: Government Employees Health Association (GEHA) Medicare $847.58
Rate for Payer: HealthUtah PPO $3,026.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,935.22
Rate for Payer: Multiplan Medicare/VA $720.44
Rate for Payer: One Health Plan of WY PPO $2,965.48
Rate for Payer: PacificSource Commercial $2,723.40
Rate for Payer: PHCS PPO $2,874.70
Rate for Payer: Three Rivers PPO $2,269.50
Rate for Payer: TriWest Veterans Administration $847.58
Rate for Payer: United Healthcare Commercial $2,632.62
Rate for Payer: United Healthcare Medicare $847.58
Rate for Payer: WINHealth Partners Commercial $2,572.10
Service Code HCPCS 27880 AS
Hospital Charge Code 27880
Min. Negotiated Rate $720.44
Max. Negotiated Rate $3,026.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $2,965.48
Rate for Payer: Aetna of WY Medicare $847.58
Rate for Payer: Beech Street Commercial $2,874.70
Rate for Payer: Cash Price $2,118.20
Rate for Payer: Cash Price $2,118.20
Rate for Payer: ChoiceCare Network Commercial $2,935.22
Rate for Payer: Cigna of WY Commercial $2,965.48
Rate for Payer: First Choice Health Commercial $2,723.40
Rate for Payer: Government Employees Health Association (GEHA) Commercial $2,874.70
Rate for Payer: Government Employees Health Association (GEHA) Medicare $847.58
Rate for Payer: HealthUtah PPO $3,026.00
Rate for Payer: Idaho Integrated Healthcare Commercial $2,935.22
Rate for Payer: Multiplan Medicare/VA $720.44
Rate for Payer: One Health Plan of WY PPO $2,965.48
Rate for Payer: PacificSource Commercial $2,723.40
Rate for Payer: PHCS PPO $2,874.70
Rate for Payer: Three Rivers PPO $2,269.50
Rate for Payer: TriWest Veterans Administration $847.58
Rate for Payer: United Healthcare Commercial $2,632.62
Rate for Payer: United Healthcare Medicare $847.58
Rate for Payer: WINHealth Partners Commercial $2,572.10
Service Code HCPCS 27882 AS
Hospital Charge Code 27882
Min. Negotiated Rate $475.14
Max. Negotiated Rate $1,997.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,957.06
Rate for Payer: Aetna of WY Medicare $558.99
Rate for Payer: Beech Street Commercial $1,897.15
Rate for Payer: Cash Price $1,397.90
Rate for Payer: Cash Price $1,397.90
Rate for Payer: ChoiceCare Network Commercial $1,937.09
Rate for Payer: Cigna of WY Commercial $1,957.06
Rate for Payer: First Choice Health Commercial $1,797.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,897.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $558.99
Rate for Payer: HealthUtah PPO $1,997.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,937.09
Rate for Payer: Multiplan Medicare/VA $475.14
Rate for Payer: One Health Plan of WY PPO $1,957.06
Rate for Payer: PacificSource Commercial $1,797.30
Rate for Payer: PHCS PPO $1,897.15
Rate for Payer: Three Rivers PPO $1,497.75
Rate for Payer: TriWest Veterans Administration $558.99
Rate for Payer: United Healthcare Commercial $1,737.39
Rate for Payer: United Healthcare Medicare $558.99
Rate for Payer: WINHealth Partners Commercial $1,697.45
Service Code HCPCS 27882
Hospital Charge Code 27882
Min. Negotiated Rate $475.14
Max. Negotiated Rate $1,997.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,957.06
Rate for Payer: Aetna of WY Medicare $558.99
Rate for Payer: Beech Street Commercial $1,897.15
Rate for Payer: Cash Price $1,397.90
Rate for Payer: Cash Price $1,397.90
Rate for Payer: ChoiceCare Network Commercial $1,937.09
Rate for Payer: Cigna of WY Commercial $1,957.06
Rate for Payer: First Choice Health Commercial $1,797.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,897.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $558.99
Rate for Payer: HealthUtah PPO $1,997.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,937.09
Rate for Payer: Multiplan Medicare/VA $475.14
Rate for Payer: One Health Plan of WY PPO $1,957.06
Rate for Payer: PacificSource Commercial $1,797.30
Rate for Payer: PHCS PPO $1,897.15
Rate for Payer: Three Rivers PPO $1,497.75
Rate for Payer: TriWest Veterans Administration $558.99
Rate for Payer: United Healthcare Commercial $1,737.39
Rate for Payer: United Healthcare Medicare $558.99
Rate for Payer: WINHealth Partners Commercial $1,697.45
Service Code HCPCS 27882 80
Hospital Charge Code 27882
Min. Negotiated Rate $475.14
Max. Negotiated Rate $1,997.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,957.06
Rate for Payer: Aetna of WY Medicare $558.99
Rate for Payer: Beech Street Commercial $1,897.15
Rate for Payer: Cash Price $1,397.90
Rate for Payer: Cash Price $1,397.90
Rate for Payer: ChoiceCare Network Commercial $1,937.09
Rate for Payer: Cigna of WY Commercial $1,957.06
Rate for Payer: First Choice Health Commercial $1,797.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,897.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $558.99
Rate for Payer: HealthUtah PPO $1,997.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,937.09
Rate for Payer: Multiplan Medicare/VA $475.14
Rate for Payer: One Health Plan of WY PPO $1,957.06
Rate for Payer: PacificSource Commercial $1,797.30
Rate for Payer: PHCS PPO $1,897.15
Rate for Payer: Three Rivers PPO $1,497.75
Rate for Payer: TriWest Veterans Administration $558.99
Rate for Payer: United Healthcare Commercial $1,737.39
Rate for Payer: United Healthcare Medicare $558.99
Rate for Payer: WINHealth Partners Commercial $1,697.45
Service Code HCPCS 28810
Hospital Charge Code 28810
Min. Negotiated Rate $347.40
Max. Negotiated Rate $1,457.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,427.86
Rate for Payer: Aetna of WY Medicare $408.70
Rate for Payer: Beech Street Commercial $1,384.15
Rate for Payer: Cash Price $1,019.90
Rate for Payer: Cash Price $1,019.90
Rate for Payer: ChoiceCare Network Commercial $1,413.29
Rate for Payer: Cigna of WY Commercial $1,427.86
Rate for Payer: First Choice Health Commercial $1,311.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,384.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $408.70
Rate for Payer: HealthUtah PPO $1,457.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,413.29
Rate for Payer: Multiplan Medicare/VA $347.40
Rate for Payer: One Health Plan of WY PPO $1,427.86
Rate for Payer: PacificSource Commercial $1,311.30
Rate for Payer: PHCS PPO $1,384.15
Rate for Payer: Three Rivers PPO $1,092.75
Rate for Payer: TriWest Veterans Administration $408.70
Rate for Payer: United Healthcare Commercial $1,267.59
Rate for Payer: United Healthcare Medicare $408.70
Rate for Payer: WINHealth Partners Commercial $1,238.45
Service Code HCPCS 28810 80
Hospital Charge Code 28810
Min. Negotiated Rate $347.40
Max. Negotiated Rate $1,457.00
Rate for Payer: Aetna of WY Commercial/Medical Rental $1,427.86
Rate for Payer: Aetna of WY Medicare $408.70
Rate for Payer: Beech Street Commercial $1,384.15
Rate for Payer: Cash Price $1,019.90
Rate for Payer: Cash Price $1,019.90
Rate for Payer: ChoiceCare Network Commercial $1,413.29
Rate for Payer: Cigna of WY Commercial $1,427.86
Rate for Payer: First Choice Health Commercial $1,311.30
Rate for Payer: Government Employees Health Association (GEHA) Commercial $1,384.15
Rate for Payer: Government Employees Health Association (GEHA) Medicare $408.70
Rate for Payer: HealthUtah PPO $1,457.00
Rate for Payer: Idaho Integrated Healthcare Commercial $1,413.29
Rate for Payer: Multiplan Medicare/VA $347.40
Rate for Payer: One Health Plan of WY PPO $1,427.86
Rate for Payer: PacificSource Commercial $1,311.30
Rate for Payer: PHCS PPO $1,384.15
Rate for Payer: Three Rivers PPO $1,092.75
Rate for Payer: TriWest Veterans Administration $408.70
Rate for Payer: United Healthcare Commercial $1,267.59
Rate for Payer: United Healthcare Medicare $408.70
Rate for Payer: WINHealth Partners Commercial $1,238.45